1. Field of the Invention
This invention is related to endotracheal tube holders which hold an endotracheal tube in a patient's mouth during mechanical ventilation.
2. Description of the Prior Art
A patient may require an endotracheal tube to assist with the patient's breathing. An elongated tube is passed through a patient's mouth and into the trachea, and an inflatable exterior cuff on the tube is used to seal the trachea about the tube. The external end of the endotracheal tube is connected to a ventilation system in a known manner.
It is important to physically secure the endotracheal tube to the patient to keep the tube from being accidentally removed, crimped or the like. Adhesive tape has been used to secure the tube, but the tape is uncomfortable for a patient and has a tendency to traumatize a patient's skin. A number of endotracheal tube holding devices have been proposed in the art. A complicated structure has been proposed in U.S. Pat. No. 4,744,358, and sold by Respironics Inc. as the "SecureEasy.RTM." endotracheal tube holder. While this device does adequately hold an endotracheal tube in place, its complicated headgear/strap arrangement makes it inconvenient for use by nursing personnel. Other endotracheal tube holders are shown in U.S. Pat. Nos. 3,760,811; 3,774,616; 3,976,080; 3,946,742; 3,993,081; 4,249,529; 4,326,515; 4,344,428; 4,351,331; 4,378,012; 4,437,463; 4,449,527; 4,520,813; 4,537,192; 4,548,200; 4,622,034 and 5,009,227. Other medical tube holding devices are shown in U.S. Pat. Nos. 3,987,798; 4,282,871; 4,571,245; 4,660,555; 4,739,757 and 4,774,946.
The devices shown in the above-identified patents have a common characteristic in that the endotracheal tube is held in one position and cannot be readily moved. When the tube is held in a fixed position beyond a certain period of time, damage to a patient's mouth and/or lip tissue occurs. This is a particular problem with critical care and other patients who require the use of an endotracheal tube over an extended treatment period.
It is, therefore, an object of the present invention to provide an endotracheal tube holder which permits the tube to be moved to different positions with respect to a patient's mouth and/or lips.
U.S. Pat. No. 4,223,671 describes an endotracheal tube holder which permits a limited degree of motion of the tube. However, this device requires considerable force to move the tube holder, offers little degree of movement, and includes a faceplate which completely covers and contacts a patient's lips. Thus, tissue damage to the patient's lips is not avoided. Moreover, access to the patient's mouth is not possible without completely removing the tube holder.
It is, therefore, a further object of the present invention to provide an endotracheal tube holder which permits considerable movement of the tube holder, and avoids mouth and lip tissue damage, yet leaves a patient's mouth and lips substantially uncovered and accessible. It is an object of the present invention to provide an endotracheal tube holder which is easy to install and use, is comfortable to the patient, and permits easy movement of the tube between a large number of different positions without disturbing the patient to any significant degree.